bisoprolol

how long does it take to get Bisoprolol out of your system

[mjames1]

I've read from 3 days to a week, however, depending on the dose, tapering is often recommended rather than abrupt withdrawal. You should only stop beta blockers under a doctor's supervision and follow their instructions.

Jim

[Hidden]

Hiya,

I totally agree with Jim in his post. Bisoprolol is a naughty little number. I think there may be something in the bit of paper in the packet, but gradual withdrawal over time is essential and preferably done under GP's supervision. The other thing is it could be influenced by the existing dose you are on. However, some people do it themselves, and I'm one of those - THAT SAID ... I've have never come off it all together but I have reduced my dose ... from 7.5 mg per night down to 5.0 mg per night. I did this because I was fed up with being like the Zombie from the land of the living dead. I tried to discuss this with my GP but even getting a phone consultation under the NEW NHS was proving tiresome. Eventually in her own time and space she rang me but by then I had started the process of withdrawal myself. I told her what I'd done and although she wasn't happy I gone ahead myself she didn't disagree.

So, (with the help of a pill cutter) I dropped the reduction of 2.5 mg over 30 days, in 3, 10 day rests ......... I reduced by 1 mg from 4 August to 14 Aug, so that was 7.5 down to 6.5 ...... then the next 10 days down by another 0.5mg ... then next 10 days down by a further 1 mg which got me back to 5 mg. where I've stayed ever since.

It must be said I knew perfectly well the target dose to go for (5mg) as that was what my Cardiac Consultant put me on when first diagnosed with AF in Jan 2010. It was also what suited me best. It was my GP herself that upped it to 7.5 mg in an attempt to deal with an increase in blood pressure. Why I've never been able to get to the bottom of as Bisoprolol is a HR control drug. But that's the way of the modern NEW NHS.

I must have done it all correctly as I've had no bad side effects from the reduction and no fights/rows with my GP. Hope that helps. Now I'm normal once again !!

John

[Lowell1369 in reply to Hidden]

It's wrong to condemn bisoprolol or any other beta blockers as some of these work for some people but not others... That's the complication with medications and at the end of the day we must all educate ourselves and advocate for ourselves otherwise doctors just go about doing what they do without hearing from us....

Here's my story...

I have been on several beta blockers over the years and they are wonderful drugs when they agree with you. I started on Metoprolol when I was first diagnosed with AFIB in 1997. For the short time I took this medication I felt like I was carrying around a giant weight on my head and felt groggy all the time. Once I was switched to Atenolol those feelings disappeared and I took Atenolol until recently ( 20 years) when I developed bradycardia (slow heart beat). I was then put on Bisoprolol which agreed with me however my afib was not controlled adequately. I was then put on Sotalol which also agrees with me and helps control afib. Sotalol too slowed my heart beat down into the 30's so this past March I was given an subdermal pacemaker that doesn't allow my heart rate to drop below 60 beats per minute. This has made a huge difference for me.. My cardiologist insisted I go on blood thinners which I resisted until last year as I practice holistic medicine to a point and take Serrapeptase (a natural anticoagulent) every morning and practice earthing which naturally thins the blood. I had at the time a lot of stress in my life and most of my meds stopped working properly. So along with being put on Sotalol and Candesartan for high bp I was also put on blood thinners to reduce the likelihood of a stroke according to my doctor. Almost one month to the day I ended up in emergency 3 days out of the next 5 right before NewYears 2022....with uncontrolled bleeding from my nose and it was profuse and it took three visits by ambulance finally for it to finally stop even after I ceased the blood thinners. So ablation for afib is a no go for me here in Canada as they require the patient to be on thinners a month before the procedure....so I live with my afib..and drugs....Sotalol..Candesartan..Amlodipine along with a baby aspirin and serrapeptase which I take in the morning dose..and then earth frequently throughout the day on an earthing mat under my desk as well as sleeping connected to the earth while I sleep . I am well aware of the risk I face from a blood clot when I do go into afib however blood thinners will never enter my body again and I accept the risk as I feel I am doing a lot of things that do work even though they aren't accepted by mainstream medicine. I strongly recommend looking into EARTHING... It has changed my life so much by reducing pain and inflammation... earthing.com/pages/what-is-...

😆

[Hidden in reply to Lowell1369]

Hi,

I stand corrrected ..... but am unsure why.

I never condemned Bisop, merely explained a process that my GP took me through which was successful. You seem well versed in drugs, perhaps you could explain to me why Bisoprolol is used as a high blood pressure medication, when it is for HR control. Even my GP has failed to explain on this score.

[PleasantPink]

I had to request my EP cardiology wean me off Bisoprolol because of brain fog and fatigue. I was on 2.5mg daily and we weaned on an every other day schedule for a week and then stopped. BIGGEST mistake ever. I went into hypertensive , hyperanxiety state for months requiring Lisinopril until the rebound hypertension settled down. Then I was allowed to wean off the lisinopril with my medical cardio approval. So a word of caution here, go very slow & under your doctors supervision. After all that the EP doc prescribed another beta blocker to use as needed for palpitations. I don't think I will ever use another BB unless I'm dying, and then it's a maybe !

[mav7 in reply to PleasantPink]

PleasantPink

May I ask your HR and BP ?

And had your AFib been controlled by a procedure and meds not needed ?

[PleasantPink in reply to mav7]

Without any antihypertensive med or rate control meds my range now can be 89/68 - 114/75 and HR 58-84. I was on Multaq & Ranexa for approx 2 years for rhythm & rate control for the first & only AF event. When I didn't experience any breakthrough issues i asked the EP cardio if I could try the PIP ( pill in the pocket approach which essentially is to take it per AF event ). All was well for about 4 months until I was having excess PVC's, PAC's. That's when the Bisoprolol 2.5 daily was added to reduce those, but I never had hypertension. After months on that the side effects were interfering with work. I had serious brain fog and fatigue. So back I go asking to switch that to PIP , he agrees but the withdrawal triggered a rebound hypertension that then required an antihypertensive to manage the BP spikes as high as 164/84. You can imagine how I felt when my normal BP is low to normal before this. Then I had to work thru the weaning of the Lisinopril because my BP was too low. So now I am back within my normal range and added mag chloride to suppress the PVC's & PAC's with very good results. Hope that helps you.

[mav7 in reply to PleasantPink]

Appreciate detailed reply.

Best to you in managing your health.

[PleasantPink in reply to mav7]

Thank you, same to you

[Ronnieboy]

I used to be on bisoprolol 2.5 then 3.75 for a few years ,then my GP thought my HR was to low so I was taken off over a period of a few months ,I was then told to take 1 as and when needed,but I've never had to and I've not had an AF attack for a few years now.My HR is still low however, high 40s to high 50s but the powers that be seem to think that's no problem.

[Shcldavies]

your body gets use to it so gradually withdrawal best, don’t be surprised if you have some ectopics or palpitations from day 4, stay with it, if your can last another week without the side effects being too bad you should be ok. If you start getting arythmia then start taking it again and see your Dr for alternative.

[Ppiman]

I can detect its effect for about two days.

Steve

[mav7]

Hi Garden

nhs.uk/medicines/bisoprolol...

Are you thinking of stopping Bisoprolol permanently or transitioning to another drug ? Best to check with your doctor.

Above is a Q&A on Bisoprolol.

[Hidden in reply to mav7]

I do realise that mav7 and thank you , but I simply can’t get to see a doctor as when I tell the receptionist the reason why I want to see a doctor , she refers me to their pharmacist and I said it’s got to be a doctor , she then informs me that the pharmacist will talk to the doctor on my behalf , I’m flabbergasted,

[Hidden in reply to Hidden]

Hi,

Since the new NHS has emerged in the national landscape my relationship with my GP has deteriorated to rock bottom. That said my surgery has appointed a Pharmacist. So, I now deal with her, so far reasonably successfully. But I know she gets in the ear of my GP !

BUT, I also deal with my Senior Pharmacist in any Pharmacy in the High St. ......this is where I get best value. Frankly I use my GP for medical certificates for work, for repeat prescriptions and for my INR Clinic. Apart from that my GP and surgery are as much use as a chocolate fireguard.

I'll take the High St. Pharmacist any day over a GP.

John

[Teresa156 in reply to Hidden]

Hi Garden3slids,

How much Bisoprolol are you on and how long have you been taking it? If you’re sufffeting side effects, have you considered just reducing slowly to a lower dose, rather than stop?

Is it not worth talking to the GP’s pharmacist after all…or could you try and say to the receptionist that you want to discuss your Afib with the GP and not mention anything about your doseage to her ? GPs aren’t actually the best at Afib, but I know we don’t have much of a choice these days, but are you under Cardiology at the hospital as well for your Afib?

If you are intending to stop/withdraw and as others have said, you must, must do it very slowly, honestly.I was on 2.5 mg Bisoprolol for just 6 weeks before a cardiologist agreed I could try and come off it and I reduced over just a week too ( as they told me to) and like Pleasantpink above, it was awful. I won’t go into detail, but the rebound effect made my anxiety go into overdrive and I went straight into Afib. So I suppose in my case, the bisop was out of my system within 24 hrs, but the after effects weren’t. I have been back on it ever since at a reduced dose now of 1.25 and ( touchwood) it keeps my Paroxysmal Afib very well controlled. I took nearly 4 months to reduce my dose from 2.5 to 1.25 and my heart didn’t seem to notice, so it can be done. I think stopping it is a totally different matter though, from my experience.

[intheweeds]

My body took several weeks just to get back to normal after stopping bisoprolol 1.25.The bisoprolol affected my liver gamma GT levels and lowered my heart rate. All took a while which i find very interesting.

[frazeej]

As the name implies, the beta blockers most of us take are blockers of the beta2 receptor for adrenaline. This will both lower the heart rate, AND decrease the force of the heart contraction, and thus the blood pressure lowering effect.

[Hidden in reply to frazeej]

That being the case Bisoprolol has never done anything for my BP, nothing at all - all it did when my GP upped my dose from 5 to 7.5 was create in me the Zombie from the land of the living dead and I couldn't function. It never did anything for BP that wasn't already being done by the 5 mg dose and the more recognised bog standard BP medication like Ramipril and Felodopine. Thanks anyway. My GP and I don't get on .... small wonder she couldn't or wouldn't explain that to me.

[Teresa156 in reply to Hidden]

Hi John,

Bisoprolol, even at 1.25 has in fact lowered my BP too, (even though it’s not wanted or needed), as it was already on the lower side of normal. Something they never even asked in A&E when they dished it out to me. My BP is regularly around 100/65 or thereabouts now. It was even lower on 2.5, but there you go. Perhaps some people are affected and some aren’t, as they affect us all in so many different ways.

[PleasantPink in reply to Teresa156]

May I ask if the bisoprolol was not wanted or needed , why are you on it ?

[Teresa156 in reply to PleasantPink]

Hi PleasantPink,

I was put in it initially by A&E for paroxysmal Afib. I’ve had it for about 17 years now, but it was never ‘caught’ on an ECG. They told me I’d have to take it every day. I was getting episodes every three weeks for about 4 months at that time, when previously I’d had them only about once a year or so. I tried to come off at that time, as I couldn’t tolerate the side effects of tiredness and brain fog etc and I wasn’t sleeping well. Like you, I found it awful to try and come off and was told to do it over just one week. The intention was I’d take it as a PIP. I’ve never experienced anything like it and I imagine it must be the same as what happened to you.

To be honest, now I’m taking 1.25 instead of 2.5, it’s better, though not perfect. I only had one episode last year and I know what triggered that) so it must be helping and doing it’s job. HR still quite low though at times, but medics say it’s ok. If I try and come off it completely again, I’d do it over 4 months or more ( I dropped by .2mg every few days using jewellery scales!)

You did so well getting off it, but had to go through a lot to do that, with the added medication to counteract the side effects. So do you no longer have Afib episodes?

[PleasantPink in reply to Teresa156]

I'm sorry for not replying sooner. I'm actually only on here occasionally. To answer your question, no I have not had any Afib episodes since stopping Multaq & Ranexa approx two years now. The Bisoprolol was to manage excessive PAC's & PVC's . While it was effective the side effects of brain fog & fatigue were not tolerable & I could hardly function at work. So they diagnose me as having Parosysmal Afib. I have meds to take on the PIP protocol ( pill in the pocket ) and I monitor my vitals every morning plus use the Kardia monitor. I don't think my EP cardio was thrilled with my request to do this but he said if I am monitoring as I said I will catch it if it returns. In the meantime he says he doesn't know why it stopped. Hope you are having a more stable time now.

[frazeej in reply to Hidden]

Effects (and side effects) are measured with what's called a "dose-response curve". As the dose is increased, the response will increase until the graph "plateaus"-at that point an increased dose will have a minimal/no increase in the response. In your case, the bisoprolol (and most beta blockers), you experienced a blood pressure effet up to 5mg, (black line) but above that not so much, BUT increasing the dose yielded a more vigorous "side effect profile", the zombie effect (red line). Increasing doses will sometimes have unintended consequences! (NOTE: This is a hypothetical graph, there is not always this relationship between desired and undesired effects.)

Hypothetical Dose Response Curve

[PleasantPink in reply to frazeej]

Very good explanation. Now if we could get some of our doc's to adjust doses according to this curve. I think sometimes meds are switched too soon or often, when a simple dose adjustment would suffice. Instead the patient now has to potentially adapt to a new med when a lower dose of the current med would have sufficed.

[frazeej in reply to PleasantPink]

>>could get some of our doc's to adjust doses according to this curve<<. More easily said than done! Believe it or not, my GP did not understand what a dose response curve was....finally, he just said fine, and changed the dosage as I requested! And, it worked!

[Hidden in reply to frazeej]

Thanks for the trouble you have taken and I do understand the two curves. So basically Bisoprolol is these days a multi purpose drug which has very little affect BP or HR wise on some patients whereas when my Cardiac Consultant initially ( in Jan 2010 ) prescribed it it was primarily, first and foremost a HR control drug. Amazing how stuff gets twisted and distorted over time. At least for me it is holding (and has done for years) my HR at 64 to 67 bpm much more of a factor in controlling my AF than lowering my BP .......... which Ramipril and Felodopine are doing very well. Hey Ho!

[PleasantPink]

I totally agree with mjames1. That said while I tapered under my EP cardio directions 2.5mg every other day for a week and then stop. Unfortunately my system did not agree & I had a rebound hypertension and high anxiety. When I notified the doc they said I was already weaned so basically tough it out a little longer it will subside. Well it did not. I needed to reach out multiple times to my Medical Cardio to finally get it back in control using small doses of Lisinopril for a few months. Then gradually weaned off and only using Magnesium chloride daily to suppress multiple PVC 's & PAC's. ( I use the Kardia mobile device daily & daily monitor BP )

[Hidden]

Hiya,

Look I've just trawled through all these posts and find that in most cases Bisoprolol is discussed here as a BP control drug. It bloody well isn't ........... it is a heart rate (beats per minute of the poor old ticker) control drug .......... WITH ....... it seems to me some dubious properties that lend themselves to BP control. To me - a cynical old git - it seems that Big Pharma has got into the mind set of the NHS and its lousy mob of surgeries to increase Big Pharma sales by putting into the medication something that is alleged to help BP control.

So where does that leave Ramipril and Felodopine ? which are specific BP control drugs.

John

[Aurealis in reply to Hidden]

Bisoprolol, to me it’s the devils potion.

[Hidden in reply to Aurealis]

it was to me originally, until the dose time was changed .... now its more an elixir of life ....if u get my drift